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Anatomic and Preliminary Apply Study of Superficial Inferior Epigastric Artery Flap in Reconstruction of Head and Neck Defect

Author: WangXiaoMin
Tutor: ZhangKai
School:
Course: Oncology
Keywords: Abdominal artery Surgical flaps Applied anatomy Head and neck reconstruction
CLC: R322
Type: Master's thesis
Year: 2011
Downloads: 20
Quote: 0
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Abstract


Objective: To study the anatomy of the superficial inferior epigastricartery(SIEA) flap and explore its clinical application in the reconstruction of head andneck defects. Methods: The origin,course,branch,distribution,diameter,pediclelength and neighbour of superficial inferior epigastric artery and vein wereobserved in10adult corpses perfused with red latex through artery and the operationswere imitated on1adult cadaver. Both side of SIEA in30nornal volunteers wererandomly investigated with Color Dopple Flow Imaging (CDFI).The occurrencerate、diameter、course、mean velocity.etc. were recorded.all these date were analyzedstatistically.Meanwhile, clinic cases in our hospital and corraletive domestic andforeign literature about SIEA flaps were Consulted and analyzed.Results: In our series of10cadaver(20sides) dissections,the SIEA was identified in18and the vein (SIEV) in20at the Level of the inguinal ligament. In11of these theSIEA arose aspart of acommon trunk with one or More other vessels. There are fourbranch modes of SIEA,5single trunks、3double ramificationsingle、7lateralramificationsingle and3medial ramification.In8cases, the venous drainage was as anindividual vein.In12cases, both patterns were observed(a pair of venae comitantesand an individual vein). The caliber of SIEA ranged from0.85to2.43mm with amean of1.48mm.The length of SIEVranged from2.56to7.02cm with a mean of4.80cm. The mean caliber of SIEV was2.33mm,The mean length of SIEA was5.45cm.60sides of the lower abdominal wall studied by Color Dopple Flow Imaging,52sidesof SIEA (86.7%)and60sides of SIEV (100%)were observed.In the rest of8sides,6 sides did not found SIEA and the other2SIEA courses were not clear.The origincaliber of SIEA(D1)is:1.73±0.22mm andThe caliber of the inguinal ligament Level(D2)is:0.81±0.16mm.The pulse stream velocity (PSV)is:23.08±6.83cm/s. Resistentindex(RI)is:0.60±0.17.The clinical effect was satisfied and Flap success rate was96.5%.Conclusion:1、The inferior epigastric artery flap can be applied to microsurgicalflap transfer, potentially in reconstruction of head and neck defects.2、Fine technical skills are necessary to dissect and anastomose the small and shortpedicle vessels for the superficial inferior epigastric artery flap.3、The Color Dopple Flow Imaging could show the distribution and location of SIEAclearly and it provides more scientific and accurate evidence for preoperative flapdesign and is worthy of clinical application.

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